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Shayne C. Gad - Safety evaluation of medical devices

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Safety evaluation of medical devices: summary, description and annotation

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This practical reference examines the implications of biological and chemical interactions of medical devices with human tissue -- offering comprehensive coverage on the evaluation of safety in specialty devices, medical and surgical supplies, imaging systems, in vitro diagnostics, and health information systems.

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Cover

title Safety Evaluation of Medical Devices author Gad Shayne C - photo 1
title:Safety Evaluation of Medical Devices
author:Gad, Shayne C.
publisher:CRC Press
isbn10 | asin:0824798279
print isbn13:9780824798277
ebook isbn13:9780585381336
language:English
subjectBiomedical materials--Testing, Biomedical materials--Toxicity testing, Biocompatibility--Testing, Materials Testing, Biocompatible Materials, Toxicity Tests, Equipment Safety, Equipment Failure.
publication date:1997
lcc:R857.M3G33 1997eb
ddc:681/.761/0287
subject:Biomedical materials--Testing, Biomedical materials--Toxicity testing, Biocompatibility--Testing, Materials Testing, Biocompatible Materials, Toxicity Tests, Equipment Safety, Equipment Failure.

Page null03

SafetyEvaluation of MedicalDevices

Page i

SafetyEvaluation of MedicalDevices

Shayne Cox Gad

Gad Consulting Services

Raleigh, North Carolina

Page ii ISBN 0-8247-9827-9 The publisher offers discounts on this book - photo 2

Page ii


ISBN: 0-8247-9827-9


The publisher offers discounts on this book when ordered in bulk quantities. For moreinformation, write to Special Sales/Professional Marketing at the address below.


This book is printed on acid-free paper.


Copyright 1997 by Marcel Dekker, Inc. All rights reserved.


Neither this book nor any part may be reproduced or transmitted by any form or byany means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission inwriting from the publisher.


Marcel Dekker, Inc.

270 Madison Avenue, New York, New York, 10016


Current printing (last digit):

10 9 8 7 6 5 4 3 2 1


PRINTED IN THE UNITED STATES OF AMERICA


Page iii

To Joyce, my partner and best friend, for all the patience, encouragement,and support she has given me.

And to my father for all the love and wisdom he provided while here.

I miss you, Dad.

Page v

Preface

Safety Evaluation of Medical Devices has been written with the sole objective ofproviding a practical guide for those who are responsible for, or concerned with, ensuringthe safety of medical devices for patients, health care providers, and those involved intheir manufacture. As such, the basic aspects of device regulation and materials utilizedin devices have been addressed. In areas where it was deemed appropriate, the historyand underlying science have also been presented to allow the reader to make moreinformed decisions.

This volume attempts to present a road map for the device and device materialsafety evaluation process as part of the overall development of new products. It reflectsthe experience and judgment of the author. It is my hope that it provides a utilitarianyet scientifically valid path through the everyday challenges of safety evaluation forall those involved.

I owe the greatest thanks to Joyce Todd for her help in proofreading this manuscript,as well as assisting me with the word processing. I am also grateful to Roger's WordService and Janine Maves for decoding my handwriting and turning out excellent firsttyped drafts of the manuscript, and to the Touchberry Group for producing finishedgraphics.

Shayne Cox Gad

Page vii

Contents

Preface

v


1 Introduction

1

I. Scope of devices and the medical device market

2

II. History

3

III. Regulatory basis

4

IV. Toxicity testing: Medical devices

9


2 Road Map to Test Selections

27

I. Key concepts

27

II. Conditions of use

27

III. Materials, components, and products

28

IV. Prior knowledge

49

V. Other testing considerations

57


3 What to Test: Sampling and Sample Preparation

65

I. Sampling

65


4 Cytotoxicity Testing

75

I. Background

75

II. Cytotoxicity assays

78

III. Conclusion

83


5 Blood Compatibility

85

I. Device types

87

II. Standard tests

91

III. Conclusion

95

Page viii


6 Irritation and Pyrogenicity

97

I. Dermal irritation

97

II. Ocular irritation testing

104

III. Other nonparenteral route irritation tests

110

IV. Parenteral irritation/tolerance

110

V. Reference standard and control standard endotoxins

118

VI. Factors affecting irritation responses and test outcome

123

VII. Problems in testing and their resolution

124


7 Immunotoxicology

131

I. Overview of the immune system

134

II. Evaluation of the immune system

146

III. Approaches to testing

179

IV. Problems and future directions

181


8 Implantation Studies

189

I. Introduction

189

II. Long-term implant studies

198

III. Considerations

206


9 Genotoxicity

209

I. DNA structure

209

II. Cytogenetics

218


10 Subchronic and Chronic Toxicity

259

I. Objectives

259

II. Regulatory considerations

260

III. Parameters to measure

262

IV Histopathology

264

V. Study interpretation and reporting

268


11 Carcinogenicity and Reproductive and Developmental Toxicity

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